Everyone is freaking out about Zika – Should I?

With tens of thousands of travelers about to descend on Rio and Brazil, a Nomad tells us why she’s not going to worry about Zika virus, and nor should you.

Holding the Olympics in Rio in 2016 has put Brazil in the travel spotlight. Despite the problems, the games have showcased this amazing country to the world, and a lot more people will now consider travel there. But there remains one persistent issue – Zika virus.

It’s up to each person to weigh up and decide for themselves the risks of travel to Brazil, but one World Nomad shares with us  her take on the health issue, and explains why she’s not worried.

Freaking out about Zika

by Johanna Read, www.TravelEater.net

Brazil in the height of summer! Dancers in the street, bikinis on crowded beaches, and caipirinhas by the pool. And floods of scary headlines about the Zika virus.

I arrived in Brazil in late January 2016, a few days before the World Health Organization declared a global public health emergency because of Zika.

Did I panic? No. Did I change my travel plans? No. Did I do anything differently? Well, maybe a little, but not for the reasons you might think.

As a travel writer and photographer I spend much of my time travelling. My first stop in 2016 was Brazil, so I’ve been reading a lot about Zika.

Initially news reports were worrisome. But upon closer scrutiny, what I found was hyperbole, scare-mongering and inaccurate reporting.

Now, I’m not a scientist or doctor. I am, however, a former policy executive with the Government Canada. My job was to sort through the evidence of experts, provide the challenge function to determine the validity of assumptions and conclusions, and make fact-based recommendations. One of the files I worked on was pandemic influenza, so I’m fairly knowledgeable about infectious diseases (on that note, get your flu shot!).

Yes, the news stories and pictures of babies with microcephaly -- a serious birth defect where the baby’s brain and head are severely underdeveloped -- are awful. But when you’re reading about Zika and travel safety, consider the following factors affecting what scientists and governments choose to share with the media, and what the media chooses to publish:

  • media outlets make money from click bait headlines and stories that encourage people to buy newspapers and magazines;
  • we still don’t have very much research on foetal development and what causes birth defects; and of course pregnant women, their families and doctors naturally want to take every precaution they can;
  • the science surrounding Zika is in the very early stages;
  • Zika is a disease hitting not just poor countries which aren’t tourist destinations, but richer countries and vacation spots in Latin America and the Caribbean;
  • the world’s health community has been criticized for ignoring and under-resourcing the deadly Ebola epidemic in western Africa that began in late 2013 and is still ongoing;
  • pharmaceutical companies are racing to develop a vaccine and the massive profits that go with it; sensational media reports help them get investments;
  • in August, the Olympics will open in Brazil with a huge influx of athletes of child-bearing age and massive amounts of media attention;
  • Brazil’s economy is sliding, inflation is rising, 1.5 million workers have been laid off, and they are on the verge of the deepest depression since they began keeping records in 1901;
  • linked to this, Brazil is in a political crisis after the government raised taxes and cut stimulus spending, and the President is facing a threat of impeachment because of a corruption scandal … diversions are welcomed.

I’m not a conspiracy theorist, but all this means I read Zika stories with a grain of salt.

What is Zika virus?

Zika is a mosquito-borne virus. It is in the flavivirus family, which includes dengue, West Nile and yellow fever.

Zika symptoms are mild, and many people don’t even report to a doctor. The U.S. Centre for Disease Control and Prevention says that four of five people with Zika don’t show any symptoms. Typical symptoms are a mild fever, an itchy red rash, headache, muscle and joint pain, and sometimes conjunctivitis (pink eye). People feel ill for a day or two, no more than a week.

Zika is not new, but it has spread quickly (more on that later). It was first identified in 1947 in Uganda, and a few cases in Africa and Asia followed. Larger outbreaks were seen in 2007 in Micronesia and in 2013 in French Polynesia.

Brazil had its first Zika cases in May 2015. Officials estimate that 1.5 million people have been infected so far. Most cases are in the north-eastern states, close to the equator, in poorer cities where there is standing water and sewer canals where mosquitoes breed, and where many citizens don't have air conditioning and sleep with the windows open.

In the same parts of Brazil, there’s been a rise in microcephaly in newborns as well as cases of Guillain-Barré, an autoimmune disease that can cause paralysis and death. However, no causation has been found, only a correlation. There’s also a correlation with the spraying of pesticides in these areas.

Brazil declared a public health emergency on November 11, 2015 due to the microcephaly cases. On February 1, 2016 the World Health Organization declared a “public health emergency of international concern”.

How much of this is political, and how much is based on science?

How is Zika transmitted?

Female mosquitoes require mammalian blood to produce eggs. After a female mosquito bites someone already infected with a virus, she can spread it to every other person she bites during her three- to four-week-long life. When a mosquito bites, she injects saliva into your skin to stop blood from clotting. The saliva transmits the virus from the mosquito to you.

It isn't yet confirmed, but it is thought that Aedes mosquitoes carry Zika. These are the same biters that carry the debilitating dengue virus, as well as other more minor viruses.

Where can i get Zika?

Not just Brazil. Thirty-eight countries, largely in the Caribbean and Latin America, have had Zika transmissions in the last nine months. Zika is spreading.

Let’s assume the Aedes mosquito is the Zika culprit. It likes warmth and is found where temperatures remain above 10° Celsius. Its territory is at latitudes between 35° north and 35° south, stopping at 1000 metres above sea level. This covers the southern United States, Spain, India, most of South America, Africa and Asia, and almost all of Australia. With climate change, the territory is expanding further.

More on mosquitoes by World Nomad’s mosquito expert Dr. Erik McLaughlin.

But if the media exaggerates and Zika is mild, why should I care?

Like most people, I like to avoid contracting any disease, especially ones we don’t know a lot about, like Zika.

While I’m not that concerned about Zika, I already take precautions when I travel to avoid two other mosquito-borne diseases:

  • Dengue is known as “break-bone fever” because it is so painful. Carried by the Aedes mosquito, there is no vaccine or cure and only minimal treatment. If you get infected by dengue twice, the disease is even more serious. Dengue kills about 20,000 people annually. (More about dengue here.)
  • Malaria is spread by a one-celled parasite carried by a different mosquito -- Anopheles. It can cause fever, fatigue, vomiting, seizures, coma and death. In 2015 there were 214 million cases and 438,000 deaths.

Protecting myself from dengue and malaria conveniently also protects me from Zika.

But remember how I said there was something I do differently after reading about Zika, but not for the reasons you might think? I take precautions against mosquito bites so I don’t spread Zika.

As a traveller, the biggest risk is causing Zika to spread

While it is pretty easy for a traveller to avoid getting Zika, it is not that easy for the citizens of many Zika-affected countries. And travellers are a main source of the spread of the disease.

Travellers tend to stay in hotels and hostels in modern buildings in good repair, without holes in screens or walls that let in mosquitos. We keep the windows closed and the air conditioning on. Even if there is no AC, we keep in the cooling air stream of a strong fan, which mosquitoes are too weak to fly in. We stay in nicer neighbourhoods where there is little standing water in which mosquitoes breed. We can afford insecticides like DEET, Icaridin/Picaridin and Permethrin.

If we do get sick, as is stands now, symptoms are minor. There is not even conclusive evidence that Zika causes birth defects, though of course pregnant women would want to be cautious and avoid bites more than average travellers.

A sick traveller can easily get medical attention at home or while travelling (you do have your World Nomads insurance, right?). We get a diagnosis, a comfortable bed, medicine, clean water and healthy food to speed along our recovery. It is rare for us to get secondary infections that lead to lengthier illnesses.

But it is not this easy for the average citizen of a developing country, who lives without luxuries like air conditioning and new mosquito nets, and without access to a developed health care system and other social supports.

While I’m not worried about contracting Zika for my own health, I am concerned about spreading the disease. If I am bitten by a Zika-carrying mosquito, I likely have the virus in my bloodstream. When I travel to another area which is not affected by Zika and I’m bitten by a mosquito there, that mosquito then becomes a carrier of Zika. When that mosquito bites someone else, I’ve then spread Zika to a new area.

We need to minimize the spread of Zika and other diseases carried by the mosquito.

Ok, I’m convinced to avoid getting, and spreading, mosquito-borne diseases.

OK, this is over-kill, no need to do this.

How do I protect myslef from Zika?

Don’t get bitten by a mosquito. This isn't actually that difficult.

Wear clothes:

  • Cover up with clothing, preferably light-coloured (not just to keep you cool, but there’s evidence to suggest mosquitoes are attracted to darker colours).
  • You can treat your clothes (and your gear) with the insecticide Permethrin. It lasts about two weeks, even after a couple washings.
That's more sensible.

Protect your skin:

  • Put DEET (or Icaridin/Picaridin) on skin you don’t cover with clothing.
  • The optimum concentration of DEET for adults is 35%, which provides about 8-10 hours of protection.
  • There’re conflicting views about whether to put on sunscreen or DEET first. Regardless, wait 10 minutes between applications so the first product dries. There’s evidence that DEET reduces the effectiveness of sunscreen, so you’ll need to reapply your sun block later in the day. Products that contain both DEET and sunscreen aren’t recommended.
  • Put DEET on again before you go out in the evening.

While the mosquitos that carry dengue, and potentially Zika, bite in the day time, malarial mosquitoes bite at night. Regardless, take these sleeping precautions:

  • Keep the windows closed and use air conditioning.
  • Sleep in the stream of a fan -- mosquitoes aren’t strong enough to fight the current of most fans.
  • If there is no AC and/or you’re in a malarial zone, sleep under a mosquito net treated with Permethrin and tuck the ends under your mattress (check for holes in the net).
  • In a malaria zone, take a prophylactic like Malarone. Malarone is a bit expensive, but it is very effective and has extremely minimal side effects. Follow the instructions precisely.

Because I’m protecting myself against dengue and malaria, I’m also protecting myself from becoming a carrier for Zika, and therefore helping protect the people in all the countries I travel to.

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